Are routine 3 month tests not routine?

[Loobyloo]

Want a bit of advise really.
Being diagnosed in June/July with hba1c of 108 and low thyroid function also kidneys needed keeping an eye on (as little low) i had my first 3 blood tests end Sept and rang for results which the receptionist advised me were normal at 40mmol. I rang again this week to get book in for my 3 month bloods and have been told i cant have any as the doctor hasn't asked they be done.
Is this normal?
I was maybe mistakenly under the impression it was routine for 3 month tests for Diabetics. If you get a normal test do they not test again at 3 months and leave you to carry on with no testing? I am on 2000mg Metformin and Levothyroxin for my thyroid which is apparently normal levels too in Sept tests.
I have a telephone appointment next week with a nurse which is first contact since being advised i was diabetic over the phone in June. I would just like to know what the usual routine is before speaking to her.
Thanks in advance.

 

[mikeydt1]

if everything comes back as normal then the doctor depending might not ask for any more bloods.
as you have diabetes and are on meds i would contact your practice as sometimes things can be overlooked or get skewed. normal would be 3 to 6 months some go even longer, mine is due at some point.

 

[Anitram]

I think it's probably a bit of a post code lottery anyway. I haven't heard anything from my surgery since I got my HbA1c into normal range back in August 2019, so my annual DN review & foot check is well overdue. Fortunately I don't have any issues at the moment. I don't know whether the silence is due to clinical discretion or Covid, although I don't see why either should stop them calling me to check how things are.

 

[Loobyloo]

I think it's probably a bit of a post code lottery anyway. I haven't heard anything from my surgery since I got my HbA1c into normal range back in August 2019, so my annual DN review & foot check is well overdue. Fortunately I don't have any issues at the moment. I don't know whether the silence is due to clinical discretion or Covid, although I don't see why either should stop them calling me to check how things are.

Yes thanks for your answer. I sort of understand them not contacting so often if you are within normal levels without medication like yourself (well done by the way) but i am on high dose of metformin which i thought they may possibly want to look at cutting sometime as i am on the more expensive SR version. Maybe it is a sign of the times and they don't have time these days and Diabetic monitoring is one of the things to suffer.

 

[rebrascora]

Whilst you are likely to get 3 monthly checks when your levels are dangerously high like yours were at diagnosis, once you are controlling things well then 6 monthly or probably annual checks would be more likely, much the same as other chronic conditions like asthma but as Martin suggests there will be an element of postcode lottery in it.

Can I just congratulate you on reducing your HbA1c by such a dramatic amount in such a short space of time... That is a really fantastic achievement!

 

[Anitram]

well done by the way

Thank you. It was hard going for a while but it's become a way of life. You seem to be on track too, so well done you.

Hope things aren't too bad for you down there in Cornwall. We love Cornwall and for each of the past 5 years we've holidayed in Fowey, though we could have done without our car breaking down on Bodmin Moor, in a storm, on the way home one year. The day before had been a lovely sunny day.

 

[helli]

Wow! Three month reviews!
I have been lucky if I get them every 12 months. It is more like every 13 or 14 ... or 15 months. This caused a problem when my driving license was due to be renewed and the form asked if I had had a diabetic review within the last 12 months for a doctor to confirm I was managing my condition without too many hypos, etc.

When I was first diagnosed, I had one appointment 3 months after diagnosis to check I was understanding insulin dosage, etc, another after 6 months and since then it is supposed to be annually.

Most of the time once every 12 months (if it happened) has suited me fine. I can see with finger pricks how my blood sugars are and, working full time, I don't want the hassle of taking a few hours off to get to late running appointments more often than necessary.

 

[Ditto]

Three months! Good grief, I wouldn't mind getting seen some time this year, wasn't seen last year and not sure about the year before! I'm not on insulin or anything, maybe that's why they don't bother about me?! Hope you get sorted.

 

[Vonny]

Blimey, this really is a post code lottery isn't it! After my initial diagnosis I had bloods done at 6 weeks, then 3 months later and they have contacted me today to book me in for this week, ie 4 months later. The DNs have been just amazing at my GP practice. BTW, I hope your DN congratulates you on reducing your hba1c so much! You deserve it

 

[Loobyloo]

Hope things aren't too bad for you down there in Cornwall. We love Cornwall and for each of the past 5 years we've holidayed in Fowey, though we could have done without our car breaking down on Bodmin Moor, in a storm, on the way home one year. The day before had been a lovely sunny day.

Cornwall has always been known for changeable weather. We often have all the seasons in one day.

 

[Loobyloo]

Oh gosh it does seem a real lottery! I was just looking at peoples history and hba1c under their diabetes signature/history and saw many seemed to be updated every 3 months so thought routine. I have never had an appointment or review with anyone and made my own appointment for bloods at 3 months and rang receptionist for results as heard nothing at all back. Well after a bit of a battle with receptionist i am finally getting a phone call from a nurse (not DN) next week. Only got that because receptionist said my notes in july said recommend statins and i said nothing has been said to me about this. She said maybe they write that on all Diabetics notes. Couldn't tell me cholesterol count. Oh well i will have to see next week.

 

[Loobyloo]

BTW, I hope your DN congratulates you on reducing your hba1c so much! You deserve it

Wow you have done very well with your weight loss too. Well done! Bet you feel like a new woman.

 

[JJay]

This caused a problem when my driving license was due to be renewed and the form asked if I had had a diabetic review within the last 12 months for a doctor to confirm I was managing my condition without too many hypos, etc.

Just had my renewal forms through. It now asks "Have you had contact (Any phone, video or face to face consultation) with your healthcare professional about your diabetes in the last 18 months?"

Amended for Covid, I assumed - but no, the form is dated Feb 2019

 

[grovesy]

Many are lucky if they get annually!

 

[DaveB]

My surgery expects me to book my diabetes review and arrange a blood test so anyone who is overdue should make sure they have asked for a review. I think NICE now says 6 months as standard rather than 12 months but not sure why. There is no excuse for a surgery to refuse a review although by phone. My nurse always agrees with me at my review when I should arrange the next one - it works well.

 

[helli]

There is no excuse for a surgery to refuse a review although by phone.

Except ...
- you can't get a blood test by phone
- some people do not like phone consultations
- GPs are busy with Covid vaccinations, at the moment
- GPs may have been reassigned to help in hospitals with Covid
- Just like everywhere else, staff are ill with Covid or shielding and not available so surgeries may be low on staff at the moment.

It is fantastic that you have such a supportive surgery but, on a good day, that is not common and, in the middle of a pandemic, it is even less common.

 

[grovesy]

Except ...
- you can't get a blood test by phone
- some people do not like phone consultations
- GPs are busy with Covid vaccinations, at the moment
- GPs may have been reassigned to help in hospitals with Covid
- Just like everywhere else, staff are ill with Covid or shielding and not available so surgeries may be low on staff at the moment.

It is fantastic that you have such a supportive surgery but, on a good day, that is not common and, in the middle of a pandemic, it is even less common.

The receptionist tried to tell me on 2 differnt occasions in the summer that Diabetic reviews were telephone only. First time declined , did not see point ,second time I booked, first thing nurse said but booked me in for following week, for bloods, and other physical bits, followed by phone call the week after that for results. I am supposed to have another check next month but I am not holding out it will happen. I am more concerned about my Retinopathy Screening that is due April, and I will be 2 years since last one, as I was classed as low risk last year was deferred 2 years.

 

[DaveB]

Except ...
- you can't get a blood test by phone
- some people do not like phone consultations
- GPs are busy with Covid vaccinations, at the moment
- GPs may have been reassigned to help in hospitals with Covid
- Just like everywhere else, staff are ill with Covid or shielding and not available so surgeries may be low on staff at the moment.

It is fantastic that you have such a supportive surgery but, on a good day, that is not common and, in the middle of a pandemic, it is even less common.

Yes, surgeries vary but I get my bloods done at the local hospital which is operating for bloods. All my DN needs to do is send an electronic form to the hospital. There is no excuse not to do that. I have access to my surgeries online system including test results and we all have a right to that access. That means I can see my blood test results even if I don't have a review and I always have the review having seen my results which speeds-up the review. It is easy for surgeries to use Covid as an excuse. Tell me why should surgery staff be so ill with Covid when they hardly see patients in person currently and when they do they go thru a thorough cleaning routine.

 

[Ruby/London]

When I was first diagnosed in 2018 with T2 I had 2 follow up blood tests within 6 months and then moved to 6 monthly check ups when my BG levels stabilized and reduced through following a low carb diet. My GP told me that for normal level it is an annual check and they have followed through on that with 1 test during lockdown, followed by a telephone consultation with the Diabetic Nurse.

 

[helli]

Tell me why should surgery staff be so ill with Covid when they hardly see patients in person currently and when they do they go thru a thorough cleaning routine.

Because surgery staff don’t spend all day (and night) in the surgery. They need to buy food. They have families they live with who go to school (GPs are probably key workers so they children can go to school) or other jobs.
Surgery staff have other conditions which may mean they need to shield.
Your argument about cleaning implies hospital workers could never get coved but they do.

And some patients, who may have Covid still have to go into the surgery. For example, my blood test and retinal scan required me to go to my surgery.

And don’t forget my other examples I gave such as GPs being reassigned elsewhere such as hospitals and vaccination centres.

Covid is not an excuse. It is a good and scary reason why we may not have access to the same level of review as usual.